"The stealth epidemic of hepatitis C has finally matured, leaving a narrow window of opportunity to find those with advancing disease, connect them with care, and prevent the tragic and costly consequences of liver cancer and end-stage liver disease," Dr. Coffin said. Doctors are hampered by current overly narrow screening guidelines, and managing chronic HCV infection becomes increasingly expensive as it progresses.

Broader screening for hepatitis C would be cost effective, study suggestsLinking those infected with care is key to reducing related mortality and morbidity

Broader screening to identify people infected with hepatitis C virus (HCV) would likely be cost effective, according to a new report published in Clinical Infectious Diseases and available online.
Significantly reducing HCV-related mortality and morbidity, however, will require a coordinated effort that emphasizes not only increased testing but also linking those infected with the treatment they need.

The HCV epidemic peaked many years ago, but roughly 4 million U.S. residents still suffer the consequences of chronic hepatitis C. A growing proportion of those infected now has advanced disease, including cirrhosis of the liver and liver cancer. Deaths from chronic infection have doubled over the last decade and are expected to more than double again by 2030.

The current "risk factor-based approach to screening has failed to identify at least half of those infected, leading to a situation in which a quarter of those newly diagnosed already suffer from cirrhosis of the liver," said Dr. Phillip O. Coffin, who led a team of researchers, including Drs. John D. Scott, Matthew R. Golden, and Sean D. Sullivan, at the University of Washington in Seattle who estimated the cost-effectiveness and impact of HCV screening.

Adding a one-time screening for all adults between the ages of 20 and 69 and factoring in the costs of managing late-stage liver fibrosis versus the costs of attempting to cure patients of hepatitis C, Dr. Coffin's team used statistical modeling techniques to analyze the benefit of broadening screening guidelines. They found that screening all adults was cost effective across a wide range of assumptions related to the costs and effects of screening and treatment. At the same time, the proportion of deaths averted by screening is likely to be relatively small, unless testing efforts are accompanied by substantial increases in successful referral of infected persons for treatment.

"The stealth epidemic of hepatitis C has finally matured, leaving a narrow window of opportunity to find those with advancing disease, connect them with care, and prevent the tragic and costly consequences of liver cancer and end-stage liver disease," Dr. Coffin said. Doctors are hampered by current overly narrow screening guidelines, and managing chronic HCV infection becomes increasingly expensive as it progresses.

"We need to screen the population, but that won't be enough to make a big difference," Dr. Coffin said. "Hepatitis C is a lot like HIV. The U.S. took a long time to come to the conclusion that we needed to really emphasize testing and efforts to link people to care. Hepatitis C is the same. We need a large scale, coordinated effort to identify people with this infection and make sure they get the care they need."

Clinical Infectious Diseases is a leading journal in the field of infectious disease with a broad international readership. The journal publishes articles on a variety of subjects of interest to practitioners and researchers. Topics range from clinical descriptions of infections, public health, microbiology, and immunology to the prevention of infection, the evaluation of current and novel treatments, and the promotion of optimal practices for diagnosis and treatment. The journal publishes original research, editorial commentaries, review articles, and practice guidelines and is among the most highly cited journals in the field of infectious diseases. Clinical Infectious Diseases is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing nearly 10,000 physicians and scientists who specialize in infectious diseases.

Updated Mar 3, 2015Reducing the cost of new hepatitis C drugsDaclatasvir, Harvoni (ledipasvir/sofosbuvir)/Sovaldi/Viekira Pak.
An index of articles pointing the reader to the current controversy over the high price of Sovaldi, Harvoni (ledipasvir/sofosbuvir) and AbbVie Viekira Pak.Class Action Lawsuit Challenges the Exorbitant Pricing of Gilead's Hepatitis-C Drug Sovaldi - The situation has Medicaid plans and insurers nationwide groping for the right balance. Worldwide patients are unable to afford treatment, while others wait in the wings on coverage.

U.S. FDA Approves Gileads Harvoni (Ledipasvir/Sofosbuvir)
Harvoni is the first combination pill approved to treat chronic HCV genotype 1 infection. It is also the first approved regimen that does not require administration with interferon or ribavirin, two FDA-approved drugs also used to treat HCV infection.

Both drugs in Harvoni interfere with the enzymes needed by HCV to multiply. Sofosbuvir is a previously approved HCV drug marketed under the brand name Sovaldi. Harvoni also contains a new drug called ledipasvir.Continue reading...

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Daclatasvir/VX-135..Vertex said it will license an experimental hepatitis C drug called VX-135 to Alios BioPharma..As a reminder (VX-135) is still on partial clinical hold by the FDA in the U.S. **Clinical Trials @ HCV Advocate-Vertex

How Soon Should I Get Tested After Exposure ?After the exposure (especially if the blood exposure involved another person known to have the hepatitis C virus), it is recommended that testing for the hepatitis C antibody be performed at 4 to 6 months after the exposure OR that testing for the hepatitis C virus itself (a test often called an HCV PCR or hepatitis C viral load test) be performed 4 to 6 weeks after the potential exposure. These tests are done to determine whether or not hepatitis C infection has occurred as a result of the exposure

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